The document discusses hormones secreted by the hypothalamus and anterior pituitary gland. It describes how these hormones regulate growth, metabolism, and sexual development/function by binding to receptor sites in target tissues. The hormones are released into the bloodstream and can affect multiple organs. The hypothalamus regulates hormone secretion through releasing or inhibiting factors. Some key anterior pituitary hormones discussed include growth hormone, prolactin, gonadotropins, and their functions.
This is an overview of drugs used to treat migraine with an emphasis on serotonergic drugs. This presentation was for 2nd year pharmacy students as part of a pharmacology & toxicology course and accompanies Goodman & Gilman's (12e) chapter 46. A bit of general background on 5-HT is also included.
This is an overview of drugs used to treat migraine with an emphasis on serotonergic drugs. This presentation was for 2nd year pharmacy students as part of a pharmacology & toxicology course and accompanies Goodman & Gilman's (12e) chapter 46. A bit of general background on 5-HT is also included.
Histamine, meaning ‘tissue amine’ (histos—tissue) is almost ubiquitously present in animal tissues and in certain plants, e.g. stinging nettle. Its pharmacology was studied in detail by Dale in the beginning of the 20th century when close parallelism was noted between its actions and the manifestations of certain allergic reactions. It was implicated as a mediator of hypersensitivity phenomena and tissue injury reactions. It is now known to play important physiological roles.
This ppt provides the detailed about the bradykinin and their physiological and pharmacological actions and their generation and their mechanisms in detailed manner.
Introduction to the endocrine system
Growth hormone: Mechanism of Action, secretion, regulation.
Prolactin
Sex hormones
Oral contraceptives
Corticosteroids
Histamine, meaning ‘tissue amine’ (histos—tissue) is almost ubiquitously present in animal tissues and in certain plants, e.g. stinging nettle. Its pharmacology was studied in detail by Dale in the beginning of the 20th century when close parallelism was noted between its actions and the manifestations of certain allergic reactions. It was implicated as a mediator of hypersensitivity phenomena and tissue injury reactions. It is now known to play important physiological roles.
This ppt provides the detailed about the bradykinin and their physiological and pharmacological actions and their generation and their mechanisms in detailed manner.
Introduction to the endocrine system
Growth hormone: Mechanism of Action, secretion, regulation.
Prolactin
Sex hormones
Oral contraceptives
Corticosteroids
Pharmacology Lecture Slides on Introduction to Anterior pituitary and Thyroid hormones by Sanjaya Mani Dixit Assistant Professor of Pharmacology at Kathmandu Medical College
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
How to Give Better Lectures: Some Tips for Doctors
Introduction of hormone & Anterior pituitary drugs
1. Introduction of hormone &
Anterior pituitary drugs
By
Dr. Manoj Kumar
Assistant Professor
Department of Pharmacology
Adesh Medical College & Hospital Ambala Can’t
.
2. HYPOTHALAMUS&ANTERIOR
PITUITARY HORMONES
Hormones secreted by hypothalamus and anterior pituitary
They act by binding to specific receptor sites on their target tissues.
These hormones regulate the body's growth, metabolism (the
physical and chemical processes of the body), and sexual
development and function.
The hormones are released into the bloodstream and may affect one
or several organs throughout the body.
Regulated by neuropeptides that are called either ‘ Releasing’ or
‘Inhibiting’ factors or hormones
3. General Functions of Hormones
Help regulate:
Extracellular fluid
Metabolism
Biological clock
Contraction of cardiac & smooth muscle
Glandular secretion
Some immune functions
Growth & development
Reproduction
5. General Mechanisms of HormoneAction
• Hormone binds to cell surface or
receptor inside target cell
• Then
– synthesize new molecules
– change permeability of membrane
– alter rates of reactions
• Each target cell responds to hormone differently
– liver cells-- insulin stimulates glycogen synthesis
– adipose-- insulin stimulates triglyceride synthesis
6. Control of Hormone Secretion
• Regulated by signals from nervous system,
chemical changes in the blood or by other
hormones
• Negative feedback control (most common)
– decrease/increase in blood level is reversed
hormone
• Positive feedback control
– more hormone to be released
• Disorders involve either hyposecretion or
hypersecretion of a hormone
7. Overproduction of a hormone
Underproduction of a hormone
Nonfunctional receptors that cause target cells to
become insensitive to hormones
Endocrine-related Problems
10. GROWTH HORMONE
GH
Growth Hormone (GH), 191 Amino acid, single chain peptide ,
MW 2200
GH also known as Somatotropin is a peptide hormone that
stimulates growth, cell reproduction, and cell regeneration in
humans.
With the increasing age GH secretion.
Synthetic human GH (Somatropin) is produced using recombinant
DNA technology.
11. Physiological role:
GH promotes growth by inducing hyperplasia.
But GH is not responsible for growth of brain and eye.
It promotes retention of nitrogen, Calcium & other tissue constituents
Increased uptake of amino acids by tissues and their synthesis into
proteins.
GH promotes utilization of fat and carbohydrates;
Reduce uptake of glucose by muscles but output from liver is
enhanced.
Induce lipolysis in adipose tissue.
GH mediates some anabolic effects on skeletal muscle & promotes
bone growth.
12. Pathological role:
Deficiency of GH (Lack of GHRF):
Resulting in Pituitary dwarfism.
GH used in treatment of Turner's syndrome
(chromosomal disorder), chronic renal insufficiency in
children.
GH is also used illegally by athletes to increase muscle
mass.
Excessive production of GH: resulting in gigantism
(Children) & acromegaly (adults).
In adults, benign pituitary tumour resulting excessive
production of GH. Causes enlargement of facial
structures, hands and feet.
13. Mechanism ofAction
Growth hormone stimulates liver to
secrete IGF-1 which stimulates
proliferation of Chondrocytes
resulting in bone growth.
14. Therapeutic Use
Pituitarydwarfism
Used in treatment of GH deficiency adult.
Turner syndrome
Chronic renal insufficiency
Constitutional short stature children
AIDS related wasting
Used in adults to increase lean body mass
Bone density and skin thickness
Used as an Anti AgingAgent.
.
15. PHARMACOKINETICS
Somatropin is administered by subcutaneous or IM injection.
Half life of GH is short (approximately 25 min).
Preparations/ Dosing:
For treatment of pituitary dwarfism-0.03-0.07 mg/kg (0.06-0.16
Units/kg) i.m. or s.c. 3 times a week upto the age of 20-25 years.
Treatment of excess GH secretion is with dopamine agonist
bromocriptine and octreotide is advised.
16. Adverse drug reaction:
Allergic reaction.
Pain at injection site.
Lipodystrophy (abnormal distribution of fat in the body).
Glucose intolerance.
Hypothyroidism.
Salt and water retention.
Hand stiffness & myalgia.
Raise in intracranial tension.
17. Somatostatin
14 amino acid peptide
Produce mainly by hypothalamus and also in GIT
Inhibits secretion of GH, TSH, prolactin by pituitary and
insulin, glucagon by pancreas
All GIT secretions are inhibited including (Gastrin, HCl) -
ADR
Diarrhoea, nausea, dyspepsia, stetorrhoea, hypochlorhydria .
Constrict hepatic, splanchnic and renal blood vessels
18. Uses:
Acromegaly: limited use due to short half-life (2-3 min)
GI haemorrhages (250 mcg slow IV, 3 mg infusion for 12 Hrs)
Pancreatic, biliary and intestinal fistulae – antisecretory effects
GIT tumors producing excess HCl
Diabetic ketoacidosis (inhibits glucagon and GH secretion)
Drawbacks: Short duration (2-3 min) and rebound GH secretion
19. Octreotide
Synthetic analogue of Somatostatin and 40 times more potent
Longer duration of action (t 1/2 – 90 min)
In acromegaly preferred - Injection (100 μg) s.c thrice daily
Monitor serum GH and IGF-1 levels to assess effectiveness
Goal – decrease GH levels < 2ng/ml & IGF-1 levels within
normal range.
Binds to receptors on GH secreting tumors - decreases tumor
size
Inhibits TSH secretion and is treatment of choice in thyrotrope
adenoma that over secrete TSH.
20. Other Uses:
– Secretory diarrhoeas associated with carcinoid, AIDS, cancer
chemotherapy or diabetes (100 mcg SC twice daily)
– Oesophageal bleeding (100 mcg followed by 25-50 mcg/hr)
– Used for diagnostic imaging of neuroendocrine tumors
– such as pituitary adenoma and carcinoids
• Adverse effects:
• abdominal pain, steatorrhoea, diarrhoea and gall
stones
• Lanreotide and Pegvisomant (acromegaly)
21. GONADOTROPIN-RELEASING HORMONE
GnRH
It is a dipeptide obtained from
hypothalamus.
It is essential for release of
Luteinizing hormone (LH) and
Follicle Stimulating Hormone
(FSH) from the anterior pituitary.
23. Adverse Effect
In women
Hot flushes
Sweating
Depression
Ovarian cysts
In men:
Hot flushes
Edema
Gynecomastia
24. PROLACTIN
production 199 Amino acid, single chain peptide , MW 23000
Hypothalamus regulates lactotroph cells (PRH)
Lactotrophs produce prolactin
Primary stimulate = prolaction + estrogen + progestron + other
Increase growth & development
Prolactin causes milk production
Suckling reduces levels of hypothalamic inhibition and prolactin
levels rise along with milk production
25. GH and development of breast during pregnancy.
It causes proliferation of ductal as well as acinar cells in the
breast and induces synthesis of milk proteins and lactose.
Pathological role:
Hyper prolactinaemia is responsible for the galactorrhoea,
amenorrhoea, infertility syndrome in males.
Disorders of hypothalamus decreases inhibitory control over
pituitary.
Antidopaminergic and DA depleting drugs causes hyper
prolactinaemia.
Physiological role:
26. Prolactin inhibitor:
a)Bromocriptine: synthetic ergot derivative 2-bromo-aergocryptine is a potent
dopamine agonist weak a adrenergic blocker .
b) Cabergoline: It is a newer D2 agonist; more potent; more D2 selective
and longer acting (t½> 60 days) than bromocriptine less side effects than
bromocriptine.
Pharmacological actions:
Activating dopaminergic receptors and decreases Prolactin release.
In normal individuals increases GH release but decreases the same from
pituitary tumours that cause acromegaly.
It has levodopa like actions in CNS-antiparkinsonian and behavioural effects
produces nausea and vomiting by stimulating dopaminergic receptor in CTZ.
Decreases GI motility.
27. Pharmcokinetics: Partially absorbed (1/3rd), high first pass
reaches peak plasma concentration within 1-2 Hrs, crosses BBB,
metabolites are excreted in Bile, t1/2 - 3-6 Hrs
Uses:
Hyperprolactinemia: In women it shows galactorrhoea, amenorrhoea and
infertility & men gynaecomastia, impotence and sterility.
lower doses ( bromocriptine 2.5-10 mg/ day or cabergoline 0.25-1.0 mg twice
weekly) are effective.
Acromegaly (Due to small pituitary tumours) : Slightly higher doses of
bromocriptine required (5-20 mg/day) .
Parkinsonism: Bromocriptine effective only at high doses (20-80 mg/day) and
response is similar to that of levodopa .
29. Cabergoline
• New D2 agonist
• More potent and more D2 selective
• Very long half life – 60 days or more
• Twice weekly dose
• Lesser nausea and vomiting
• Better patient compliance and tolerance
• Preferred for hyperprolactinemia and acromegaly
30. Gonadotropins – FSH and LH
FSH: induces follicular growth, development of ovum and secretion of estrogen.
In male – spermatogenesis and trophic to seminiferous tubules.
Atrophy of ovary and testes in absence
LH: Ripening of graafian follicles, triggers ovulation, rupture of follicles and
sustaining of corpus luteum.
In male stimulates testosterone secretion
Receptors: GPCR – cAMP – gametogenesis
Regulation: GnRH (FSH/LH-RH) – single releasing factor for both
Secretes in pulses – high frequency, low amplitude and low frequency, high
amplitude
estrogen and progesteron are feedback inhibitors
Also Testosterone – weak inhibitor of FSH and LH secretion
Inhibin – inhibits FSH and Dopamine inhibits LH
31. Source of gonadotropins
Preparations
– Menotropin (FSH + LH)
– Urofollitropin or pure menotropins (pure FSH)
– Placenta: human chorionic gonadotropin (hCG) – only
LH activity – urine of pregnant women
– Recombinant: rFSH and rLH
Adverse effects: Ovarian bleeding, polycystic ovary, pain
in lower abdomen – due to hyper stimulation
– Precocious puberty
– Allergic reactions (skin test)
– edema, headache, mood changes
32. uses
1. Infertility in men & women
2. Diagnosis of hypogonadism
3. Control ovarian hyp0stimulation
4. Endometriosis
5. Uterine fibroids
6. Central precocious puberty
7. Prostatic cancer
33. Gonadotropin Releasing Hormone
(GnRH)
• Synthetic GnRH – 100 mg IV – causes release of FSH and
LH
• Short plasma half-life: 4-8 minutes (rapid enzymatic
degradation)
• Used for testing pituitary gonadal axis in male and female
hypogonadism
– Desensitization of pituitary gonadotropes – loss of Gn release
34. GnRH antagonists
•
•
•
•
•
Inhibits Gn without initial stimulation
Older ones - Reactions due to histamine release
Newer – Ganirelix, cetrorelix
Used in in vitro fertilization for suppression of LH surge
Advantages:
– Quick – competitive antagonist
– Lower risk of ovarian hyperstimulation
– Complete suppression
35. Nafarelin
Long acting GnRH agonist and 150 times more potent than GnRH - Plasma
half-life 2 -3 hrs
Peak down regulation of pituitary GnRH receptors – 1 month
Goserelin:
Long acting – used as depot – Gn suppression, Ca Prostate, endometriosis
etc. – 1-3 weeks earlier before ovulation
Triptorelin
SC injection (female infertility). For long-term use – IM injection monthly
Leuprolide: Long acting IM/SC
36. ADRENOCORTICOTROPIC HORMONE ACTH
Hypothalamus secretes Corticotropin releasing hormone which
releases peptide Pro- Opiomelanocortin by the pituitary.
Then Pro-opiomelanocortin is converted into Adrenocorticotropic
hormone.
37. Physiological role:
ACTH plays a role in glucose metabolism and immune function.
The highest levels of cortisol are seen in the early morning, and
the lowest levels are in the evening.
This concept is important for diagnostic testing.
Promotes sterodogenesis in adrenal cortex by stimulating cAMP
Pathological role:
Addison‘s disease (autoimmune destruction of adrenal cortex
causes decreases level of Adrenocorticotrophic Hormone)
Cushing's disease (Increased ACTH caused by a non-cancerous
tumour called an adenoma located in the pituitary gland produces
hyperfunctioning of gland)
38. Mechanism ofAction
ACTH binds to specific receptors on the cell
surfaces of the adrenal cortex.
The occupied receptors activate G Protein-
Coupled processes to increase cAMP ,which
in turn stimulates the adrenocorticosteroid
synthetic pathway (cholesterol to
pregnolone).
40. Thyroid stimulating hormone (TSH, Thyrotropin)
It is a 210 amino acid, two chain glycoprotein (22% sugar), MW
30000.
Physiological function:
TSH stimulates thyroid to synthesize and secrete thyroxine (T4) and
triiodothyronine (T3).
Induces hyperplasia and hypertrophy of thyroid follicles and
increases blood supply to the gland.
Promotes synthesis of thyroid hormones.
Pathological role:
Hypo-or hyperthyroidism are due to inappropriate TSH secretion.
Uses:
Thyrotropin has no therapeutic use only used for diagnosis purpose
of myxoedema.